The last 48 hours.

It is notoriously difficult to predict when death will occur. Symptoms and signs of death approaching include: day-by-day deterioration, gaunt appearance and profound weakness—the patient needs assistance with all care, and may be bed-bound; difficulty swallowing medicines; reduced intake of food and fluids and drowsiness or reduced cognition. The patient is often no longer able to co-operate with carers. This article aims to give GPs in training a framework with which to manage the last 48 hours of life for patients dying at home.